HomeMy WebLinkAbout07-3455Form 668 (Y)(c)
(Rev. February 2004)
7116
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien 3 ~ . ~
Area: Serial Number
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 365278207
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer MARK A
Residence 218 0 RITNER HWY
SHIPPENSBURG, PA 17257-9756
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For Optional Use by Recordii
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
Tax Period Date of Last Dayy for
Kind of Tax Ending Identifying Number Assessment Refiling
(a) (b) (c) (d) (e)
1040 12/31/20011 XXX-XX-5716 109/11/20061 10/11/2016
1040 12/31/2002 XXX-XX-5716 03/13/2006 04/12/2016
Place of Filing
4866.86
7613.25
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 12480.11
This notice was prepared and signed at DETROIT, MI
the 16th day of May 2007
on this,
Signature A Title
ACS 11-00-0000
for DEBRA K. HURST (800) 829-7650
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Office
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Unpaid Balance
of Assessment
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part 1 -Kept By Recording Office CAT. NO 60025x